Is Kinesio tape functional or fashion?

17th October 2014

One of the more noticeable sporting trends that has seen a big increase in popularity in recent years, is ‘Kinesio Taping’ – a method of athletic therapy support using brightly coloured tape that its proponents claim brings a number of benefits to the sportsperson, including reducing pain, aiding in rehabilitation, and boosting performance.

Footballers, athletes, and tennis players have all been seen sporting the eye-catching fabric strips, as have several high-profile pro squash players in a few recent tournaments.

So does Kinesio Taping live up to all of the visibility and publicity it has received or is it just another well-marketed but ultimately over-hyped fad?

Kinesio Taping was invented by Japanese chiropractor Kenzo Kase in the 1970s. There are actually a number of other companies on the market making similar claims of similar products, but Kinesio Tape are the original and most well-known.

According to the official Kinesio.com website:

“The Kinesio Taping Method is designed to facilitate the body’s natural healing process while allowing support and stability to muscles and joints without restricting the body’s range of motion. It is used to successfully treat a variety of orthopaedic, neuromuscular, neurological and medical conditions. Both Kinesio® Tex Tape and the training protocol have shown results that would have been unheard of using older methods and materials”

The Kinesio Taping method basically involves the use of strips of bright pink/blue/black elastic tape (there’s no actual difference between the colours of the tape, beyond the aesthetics), which are placed over muscles that are injured or strained (though some Kinesio Taping therapists actually also recommend the tape for use on even fit and healthy athletes).

Prospective therapists have to undergo specialist training courses to be officially approved to use the tape/methods. The U.K. web site claims that therapists properly trained to use this taping ‘can assist in helping to alleviate pain, reduce inflammation, relax muscles, enhance performance, and aid with rehabilitation, as well as provide support to muscles during sporting events’.

Whilst taping and strappings are fairly commonly employed by many sports therapists and physiotherapists, Dr Kase claims that regular tape ‘gets in the way of the healing process by restricting the flow of inflammatory fluids below the skin’. Kinesio tape is different he says, because ‘it lifts the skin to assist this lymphatic flow, which, in turn, reduces pain and swelling’.

Despite having been around for over 30yrs now, there remains scant evidence or convincing support within the medical community for Kinesio Taping. There has been very little quality research carried out into the subject – while the Kinesio Tape website contains a list of research articles, these are mostly small preliminary or pilot studies of questionable design and unconvincing conclusions, mostly carried out by Kinesio Tape proponents and supporters.

There are few adequately designed research studies actually substantiating any of the claims made for Kinesio Tape and the associated application techniques – indeed, in July 2012 the Advertising Standards Authority investigated and upheld issues with the huge amount of far-reaching claims based in part upon the research that was advertised on the kinesiotaping.co.uk website (see here). Furthermore, a 2012 meta-analysis (a large scale study that combines and compares the results of the best pre-existing research) in the well regarded Sports Med. journal, concluded that there was ‘little quality evidence to support the use of Kinesio Taping over other types of elastic taping in the management or prevention of sports injuries’.

The authors of the meta-analysis did recommend that further research be carried out to more thoroughly evaluate the small effects and supportive anecdotes that have been reported by proponents – however even this mildly optimistic note was branded as ‘flawed’ in a critical response review in the British Journal of Sports Medicine, another well-respected publication.

More recently, a thorough systematic review published in the Journal of Physiotherapy in 2014, found that ‘current evidence does not support the use’ of Kinesio Taping for a variety of musculoskeletal conditions, including shoulder pain, knee pain, low back pain, and neck pain. A good article here further reviews some of the other research studies into Kinesio Taping, with similar conclusions.

 

So how has something that has such little solid research evidence available supporting it, become so seemingly widespread and generally accepted by a pretty large number of athletes and sportspeople?

It is an easy and very common mistake to make for us to see some athlete or another utilising some special training method/item of clothing/performance supplement and make the assumption that “if they’re using it, it MUST be good”. This fallacious ‘appeal to authority’ logic in regards to the efficacy of a given method or item, ignores the reality that being a world-class athlete doesn’t make one immune to misinformation and pseudoscience. This in addition to the simple fact that many of these athletes are actually also being paid rather a lot of money to endorse these various fads – one of the earliest and most prominent Kinesio Tape adorned athletes, beach volleyball star Kerri Walsh, was allegedly paid a significant sum to wear and endorse the materials in her Olympic games appearances.

Kinesio Tape was also reported to have donated products to 58 countries for free for use during the 2008 Olympics, which meant there was a sudden and very obvious surge in its visibility – an extremely impactful marketing trick at a time when a huge amount of eyes are on these athletes.

Marketing and promotion can be a very powerful thing – we need to look no further than the ‘breathing aid’ nose strips or ‘energy bracelets’ that were all the rage at different points in the past few years alone, which were ultimately proven to be of absolutely no benefit.

All it takes is a couple of athletes to wear or endorse something to get the bandwagon rolling – ex-Liverpool FC star Robbie Fowler almost single-handedly created the fad for the aforementioned nose strips, before they were eventually shown to provide no advantages to breathing (or anything else). The health/energy bracelet fad, on the other hand, have ‘Trion:Z’ as the latest and currently most popular variant, who give out their bracelets and sponsor a ton of athletes (including several squash players) in return for advertising their product, but who despite frequent protestations are still yet to reveal the ‘independent clinical research’ they have for all the supposed health benefits they have trumpeted on their website. A similarly marketed item the ‘PowerBalance’ bracelet was eventually forced to retract the false claims for their product after being the focus of very strong criticism by regulating authorities – we’ll take a more detailed look at some of these ‘magic wristbands’ in a future blog.

Of course, once an alleged performance-enhancing tool gains hold with a set of athletes or sportspeople, it can very quickly establish traction. Professional athletes can be an incredibly superstitious bunch, so anything that they correlate with an outstanding performance they will likely cling onto.

 

Kinesio Taping is unlikely to cause any actual performance decrement, so athletes that perform well in a given event for any reason may make a mental link between that performance and the conditions surrounding it – including any taping or strappings they may have worn for that competition. The people watching at home see this, and they then decide to try it out, and thus the fad is perpetuated despite a lack of any supporting evidence of any actual real benefits. It might be claimed that no real harm is done, but these types of interventions are rarely cheap, and someone somewhere is usually making a lot of money from them.

Whilst there are some otherwise reputable physiotherapists that are using and promoting Kinesio Taping, the majority of high profile scientists and physical therapists express severe doubts as to the efficacy of the method.

John Brewer, head of Sport & Exercise Sciences at the University of Bedfordshire, expresses his doubts and remains unconvinced of the underlying proposed mechanisms, voicing scepticism about the supposed ‘lifting’ effect and the ability of tape applied to the skin to enhance the performance of muscles deep inside the body. In his words:

“The jury is still out on the hard and fast science of it. When we exercise, it is muscles that are deep down in the body that are as much part of the energy-generating process as muscles near the skin. I’m still struggling to come to terms with how tape that is placed on skin can have any real, major effect on performance, other than potentially, a psychological effect”

He goes on to say that this psychological effect could very well be a big part of the ‘benefits’ some sportspeople either amateur or elite claim to feel, with the tape helping more as part of an athlete’s personal habits in preparation for an event, being part of their regular ritual or ‘kit’, that helps make them feel ready for action. Brewer says that if athletes think the tape will help support their muscles, then that can boost their confidence – getting somebody in the right frame of mind can make a big difference to how they perform he surmises, adding that “There isn’t any firm evidence yet to suggest the tape really does work, other than the anecdotal evidence from some athletes who say: ‘Yes, it works for us”

SquashSkills contributor and leading physiotherapist Phil Newton, a former England Squash physio and resident at the Lilleshall National Sports Centre, has also weighed in on the topic. Phil also suggests that the benefits may be all in the mind, and he believes that the striking design of the tape also plays a significant role in its popularity. He says:

“My view is that Kinesio tape probably has a significant placebo effect. The placebo effect is not fully understood but it is generally accepted that any treatment/intervention will elicit a placebo response, which has complex cultural and contextual elements.

I believe that part of the genius behind the phenomenal commercial success of Kinesio taping was the idea to manufacture it in highly visible colours. This is in contrast to the traditional colours used for traditional types of tape/bandage. Many sports performers have historically chosen to hide any strapped areas of their bodies so as not to advertise any areas of potential physical weakness. In stark contrast, many contemporary sportspeople do exactly the opposite with Kinesio tape. It seems that for many it is a badge of honour.

Maybe some wear it as a means of explaining away any possible future failures or defeats? Or maybe they want to demonstrate that they have the grit and determination to push through the adversity of injury”

There has been some vague suggestion from other researchers that it may actually be just the ‘feel’ of the tape that causes some users to report benefits from its use, but this is something very difficult to quantify. A good article here discusses this idea along with several other theorised mechanisms of effect, in respect to the complex, subjective nature of ‘pain’.

 

Ultimately, if you have used Kinesio Tape or similar and found it to be of benefit for your squash or gym training, then there is no real harm in continuing to use it. It’s generally well accepted that properly administered strapping and taping can have benefits in supporting and controlling range of motion of injured joints – Kinesio Taping and similar ‘premium’ products may well mirror some of these benefits in their own application (though you would most likely still be better served with more traditional strapping/taping from an appropriately qualified physiotherapist, along with a solid strengthening and rehab programme).

Any additional positive performance-enhancing effects reported beyond the basics of standard strapping for musculoskeletal injuries however, should be taken with a large pinch of salt. An anecdote or endorsement from an individual or even a large group of people that promises significant previously unheard-of effects, should not be taken as unquestioned evidence that the tool or method in question has any actual real out of the ordinary benefits – it is for this reason that we have scientifically controlled and double-blinded studies, to test the efficacy of any given performance-enhancing tool or intervention.

Research will no doubt continue, but the vast majority of reputable studies that have been carried out over the last 30 years for Kinesio Taping remain quite negative – fairly typical for scientifically dubious products or techniques that are developed by a ‘lone genius’ such as Dr Kase, who then tend to spend most of their time and effort promoting their product rather than submitting it for study to see if it really actually works. Even the Managing Director of Kinesio UK has conceded that ‘there’s a lot more needed on the research side’ to confirm the positive results that they report.

As it stands, Kinesio Taping can probably be seen as more of a fashion accessory than as an essential performance-enhancing tool (especially for those not suffering from any specific injury), at least until any new research or evidence comes to light.

If you’ve used it and feel it helps you on the squash court then stick with it, but there are a lot of rather more scientifically justified (and cheaper) interventions available to treat injury and/or enhance performance.

 

Gary Nisbet

B.Sc.(Hons), CSCS, NSCA-CPT, Dip. FTST
SquashSkills Fitness & Performance Director

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